So far, we have a 54 year old male who is pancytopenic.  He demonstrates features of myelodysplasia on blood film.

we have not had any clinical details, but most have suggested admission which does not seem unreasonable given the patients age and need for investigation.  If the patient is completely asymptomatic urgent outpatient review could be a possibility.

what would be your next step?

Investigations?

Think about what information is essentially in development management plan and prognosis.